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REFERENCE LINKING PLATFORM OF KOREA S&T JOURNALS
> Journal Vol & Issue
Sleep Medicine and Psychophysiology
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Journal DOI :
KOREAN ACADEMY OF SLEEP MEDICINE
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Volume & Issues
Volume 20, Issue 2 - Dec 2013
Volume 20, Issue 1 - Jun 2013
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Relationship between Sleep, Suicide, and Serotonin
Park, Young-Min ;
Sleep Medicine and Psychophysiology, volume 20, issue 1, 2013, Pages 5~9
DOI : 10.14401/KASMED.2013.20.1.005
One of hypothesis is that sleep loss related to a decrease in serotonergic activity plays a significant role in attempted suicide. A growing evidence suggests that central serotonergic activity plays a key role in the etiology of suicide. It has been reported that the cerebrospinal fluid (CSF) levels of 5-hydroxyindoleacetic acid (5-HIAA), the main metabolite of serotonin, were reduced in suicide attempters. In addition, there is evidence that tryptophan hydroxylase is associated with suicide. The association between sleep and suicide was also suggested by some researchers. Several recent studies have showed the association between sleep disturbance and suicide rates in patients with mental disorders and in a general population. In addition, it has been suggested that serotonin plays a role in maintaining arousal and regulating muscle tone and in regulating some of the phasic events of REM sleep. Especially, it is well-known that 5-HT2 receptors are related to slow wave sleep. In conclusion, it is clear that sleep, serotonin activity, and suicide are linked, although the direction of causation needs clarification. In future, large population-based cohort studies are needed to demonstrate the direction of causation in the relationships between sleep, serotonin activity, and suicide.
Sleep Disturbance and Cancer
Ban, Woo Ho ; Lee, Sang Haak ;
Sleep Medicine and Psychophysiology, volume 20, issue 1, 2013, Pages 10~14
DOI : 10.14401/KASMED.2013.20.1.010
Sleep disturbances are commonly encountered problems in cancer patients. Sleep has a role in maintenance of immunity, metabolism, and quality of life but little has been known about the prevalence, risk factors, and effects on prognosis of sleep disturbances in patients with cancer. Also little attention has been made on proper assessment and management of sleep disorders in these patients. Recently, there have been some reports that sleep disorders are related with development of many cancers such as breast, colorectal, prostate, and endometrial cancers. An intermittent hypoxia and a disruption of circadian rhythm are considered as one of the possible mechanisms of cancer developments. More aggressive evaluation and meticulous management of sleep disturbances in cancer patients are essential to improve quality of life as well as prognosis.
Mild Impairments in Cognitive Function in the Elderly with Restless Legs Syndrome
Kim, Eun Soo ; Yoon, In-Young ; Kweon, Kukju ; Park, Hye Youn ; Lee, Chung Suk ; Han, Eun Kyoung ; Kim, Ki Woong ;
Sleep Medicine and Psychophysiology, volume 20, issue 1, 2013, Pages 15~21
DOI : 10.14401/KASMED.2013.20.1.015
Objectives: Cognitive impairment in restless legs syndrome (RLS) patients can be affected by sleep deprivation, anxiety and depression, which are common in RLS. The objective of this study is to investigate relationship between cognitive impairment and RLS in the non-medicated Korean elderly with controlling for psychiatric conditions. Method: The study sample for this study comprised 25 non-medicated Korean elderly RLS patients and 50 age-, sex-, and education- matched controls. All subjects were evaluated with comprehensive cognitive function assessment tools- including the Korean version of Consortium to Establish a Registry for Alzheimer's Disease Assessment Packet (CERAD-K), severe cognitive impairment rating scale (SCIRS), frontal assessment battery (FAB), and clock drawing test (CLOX). Sleep quality and depression were also assessed with Pittsburgh sleep quality index (PSQI) and geriatric depression scale (GDS). Results: PSQI and GDS score showed no difference between RLS and control group. There was no significant difference between two groups in nearly all the cognitive function except in constructional recognition test, in which subjects with RLS showed lower performance than control group (t=-2.384, p=0.02). Subjects with depression (
) showed significant cognitive impairment compared to control in verbal fluency, Korean version of Mini Mental Status Examination in the CERAD-K (MMSE-KC), word list memory, trail making test, and frontal assessment battery (FAB). In contrast, no difference was observed between subjects who have low sleep quality (PSQI>5) and control group. Conclusions: At the exclusion of the impact of insomnia and depression, cognitive function was found to be relatively preserved in RLS patients compared to control. Impairment of visual recognition in RLS patients can be explained in terms of dopaminergic dysfunction in RLS.
Sleep and Suicidal Risk Factors in Korean High School Students
Jeong, Ja-Hyun ; Jang, Yong-E ; Lee, Hae-Woo ; Shim, Hyun-Bo ; Choi, Jin-Sook ;
Sleep Medicine and Psychophysiology, volume 20, issue 1, 2013, Pages 22~30
DOI : 10.14401/KASMED.2013.20.1.022
Objectives: Sleep problems has been consistently reported as a suicidal risk factor in adults and, recently, also in adolescents. In this study, dividing study subjects by the previous suicidal behaviors (suicidal vs non-suicidal), we compared the group differences of suicidal risk factors, and examined the possibility of sleep as a suicidal risk factor. Methods: Study subjects were 561 (271 boys and 290 girls) from a community sample of high school students. Suicidal Risk Behavior Checklist, Center for Epidemiological Study-Depression (CES-D), Symptom Checklist-90-Revision (SCL-90-R) Anxiety and Aggression subscale, Pittsburg Sleep Quality Index (PSQI) were done. Results: Forty six students (8.1%) reported previous actual self-harm behavior as a suicidal attempt, 181 students (32.4%) reported having suicidal thought only. Three hundred thirty four students (59.5%) reported no previous suicidal behavior (thought and attempt, both). Suicidal behavior group showed higher score on risk behaviors such as school violence, substance use and internet addiction. CES-D, SCL-90-R, PSQI showed significant group difference. Logistic regression analysis showed suicidal risk were significantly associated with depression, stress in suicidal risk factors and sleep latency, daytime dysfunction in PSQI. Analysis of variance (ANOVA) shows the most prolonged sleep latency and increased index of all PSQI components except sleep efficiency in suicidal attempt group. Conclusions: Sleep Problems had a strong association with the suicidal risk behavior in adolescents. Sleep problems, especially, prolonged sleep latency, daytime dysfunction might be important markers for suicidal behavior. Screening for sleep problems in adolescents are encouraged for the parents, school teachers, and related medical physicians.
Comparison between Group I in Which Non-Supine Apnea-Hypopnea Index ≥5 and Group II in Which Non-Supine Apnea-Hypopnea Index<5 in Patients with Positional Sleep Apnea
Park, Won Il ; Jung, Hye Won ; Joo, Joon Bum ; Cho, Ju Eun ; Kim, Jong Yang ;
Sleep Medicine and Psychophysiology, volume 20, issue 1, 2013, Pages 31~34
DOI : 10.14401/KASMED.2013.20.1.031
Objectives: The aim of this study was to evaluate the differences in patients with positional dependent sleep apnea according to their non-supine apnea-hypopnea index (AHI,
vs. <5). Methods: 92 patients with positional sleep apnea were evaluated. The patients were divided into two groups : group I was non-supine AHI having
; group II was non-supine AHI having less than 5. Statistical analysis was performed to find the difference between two groups. Results: In 92 patients, the number of group I patients was 11 (12%) and the number of group II patients was 81 (88%). In the severe AHI group, percentage of group I was dominated (70%) and showing a significant difference compared with the mild and moderate AHI groups (p<.05). In the severe body mass index (BMI) group, percentage of group I was dominated (54.5%) and showing a significant difference compared with of the mild and moderate BMI groups (p<.05). The percentage of group I was significantly higher than group II (p<.05) in the AHI, supine AHI, non-supine AHI and snore time. Conclusions: In patients with positional sleep apnea, severe OSA and high BMI are more common in patients with non-supine AHI
than non-supine AHI<5.
Polysomnographic Characteristics and Prescription Status of Restless Legs Syndrome Patients in Naturalistic Setting
Kang, Seung-Gul ; Nam, Ji-Hye ; Kim, Hana ; Shin, Hong Beom ;
Sleep Medicine and Psychophysiology, volume 20, issue 1, 2013, Pages 35~40
DOI : 10.14401/KASMED.2013.20.1.035
Objectives: The aim of this study is to evaluate the polysomnographic characteristics and prescription status of restless legs syndrome (RLS) patients in naturalistic setting. Methods: We reviewed medical record of the patients over 18 years olds who (i) satisfied the clinical RLS diagnostic criteria and (ii) had the polysomnography and got treatment related thereto. As a baseline, we evaluated the four diagnostic criteria of the International Restless Legs Syndrome Study Group (IRLSSG) and the International Restless Legs Scale (IRLS) of the subjects. Then the polysomnography and the suggested immobilization test (SIT) were conducted and, after one month of pharmacotherapy using dopamine agonist, the IRLS was evaluated again. Results: A total of 211 subjects participated in this analysis and 94 (44.5%) of them were male and the other 117 (55.5%) were female and the average age of the 211 subjects was
. Out of such 211 subjects, 136 subjects (64.5%) also had the obstructive sleep apnea (OSA), and 53 subjects (25.1%) also had the periodic limb movement disorder (PLMD). 185 subjects (87.7%) out of the 211 subjects had some other sleep disorders except RLS. The results of the polysomnography were as follows : 78.0% of sleep efficiency, 86.8 min of wake after sleep onset, and 3.4% of N3. More specifically, 12.4/h of the average apnea hypopnea index, 14.8/h of the periodic limb movement during sleep (PLMS), 41.2/h of the periodic limb movement during wake during SIT and 21.6/h of total arousal index during sleep. Out of the total subjects, 149 (70.6%) of them took the ropinirole and 47 (22.3%) of them took the pramipexole, and the average dosage of ropinirole was 0.9mg(dosage range 0.125-5 mg) while the average dosage of pramipexole was 0.5 mg (dosage range 0.125-4 mg). The dosage of the ropinirole showed a significant positive correlation with the age (r=0.25, p=0.002) and also with the IRLS (r=0.23, p=0.038). The IRLS at the baseline was 24.9 while the same was decreased down to 13.4 after one month. Conclusions: Analyzing the result of this study, a majority of clinical RLS subjects demonstrated comorbidity with some other sleep disorder such as the OSA or PLMD. 25.1% of the subjects showed a PLMD, which was less than in previous researches and the average PLMS was not very high as 14.8/h. The dosage of dopamine agonist taken was often a bit more than the amount recommended in Korea. A prospective research using a large scale controlled subjects will be necessary with respect to this topic.